How REM sleep deprivation and amantadine affects male rat sexual behavior

There are conflicting findings about the sexual effects of REM sleep deprivation (REMd). Otherwise, several studies show a dopaminergic hypersensitivity after REMd. The effect of REMd and amantadine (AMA) was studied for standard measures and temporal patterning in the first experiment, in four groups: normal with vehicle, normal with AMA (5.0 and 10 mg/kg), REMd with vehicle and REMd with AMA (5.0 and 10.0 mg/kg). REMd reduced mount latency (ML), intromission latency (IL) and mount number (MN) and increased copulatory efficiency (CE) and hit rate factor. REMd also reduced the mount bout number (MBN) and increased the sexual interaction (mount bout time, MBT) among male and female during copula. AMA stimulates initiation and hit rate factors and accelerates the temporal patterning of sexual behavior, evoking fewer and quicker mount bouts. In the experiments with combination of REMd and AMA administration, AMA did not increase behavior effects evoked by REM deprivation, probably due to a top or a bottom effect, depending on the measures considered. A second experiment studied the effects of AMA (1.25 to 5.0 mg/kg) and REMd on the sexual reflexes of nonimmobilized male rats. REMd enhanced the AMA effects upon the seminal emission reflex, but inhibited the penile erection reflex elicited by 1.25 mg/kg of AMA. Curiously, our results showed that REMd, like AMA, a dopaminergic agonist, causes similar effects of sexual behavior in the male rat, particularly those related to arousal mechanism and hit rate factor. The results are discussed and the effects of REMd probably involve dopaminergic hypersensitivity and increased sexual motivational response.     

The Brazilian Nursing Association in the creation,implementation and development of nursing boards

The Brazilian Association of Nursing (ABEn) was founded in 1926. The association has been the source for the creation of new professional organizations and the motivator of the development of the nursing profession in the country. The creation, implantation and development of the nursing boards are important achievements of ABEn. Twenty-eight years of struggle to approve the law number 5.905 of 12 July 1973, which created the nursing boards. Implantation of the Federal Board of Nursing (COFEn) and CORENS done under the leadership of ABEn. ABEn's participation in the development of the federal and regional boards of nursing. Current situation of the relationship between ABEn, syndicates, and nursing boards.     

A simple method for the analysis of root canal preparation

The purpose of this article is to present a simple and easy method for in vitro analysis of root canal instrumentation that permits one to observe and measure the diameter of a root before and after instrumentation, using the teeth themselves as control.     

Pediatric Escola Paulista de Medicina Range of Motion Scale: a reduced joint count scale for general use in juvenile rheumatoid arthritis

OBJECTIVE: Different instruments are available to measure functional status in juvenile rheumatoid arthritis (JRA); however, none is based on the evaluation of joint range of motion (ROM). We designed and evaluated a ROM scale to be used as a complementary instrument in daily practice with JRA as well as in trials. METHODS: The 10 joint movements of the Pediatric Escola Paulista de Medicina Range of Motion scale (Pediatric EPM-ROM) were derived from 25 initial movements. The selection was based on 2 criteria: (1) consensus among 3 pediatric rheumatologists, one physical therapist, and one occupational therapist; and (2) choice of movements that presented the highest scores in a pilot study involving patients with JRA. The score for each joint ranges from 0 (full movement) to 3 (severe limitation) and the cutoff degrees of motion are, in general, based on the lack of ability to perform some activities of daily living. The test-retest reliability was assessed by administering the scale twice by the same observer, 4 to 10 days apart, always in the morning. The interobserver reliability was evaluated on the same day by 2 independent observers. Cross sectional construct validity was also assessed by correlating the values of some clinical variables with the scores of the Pediatric EPM-ROM scale. RESULTS: The instrument was applied to 34 patients with JRA, 11 systemic, 11 polyarticular, and 12 pauciarticular. The mean EPM-ROM score was 0.57 (SD 0.54, min 0, max 2.05). The test-retest and interobserver correlation coefficients were 0.96 and 0.98, respectively. The Pearson correlation coefficients comparing scores of the Pediatric EPM-ROM scale and other variables were satisfactory: Childhood Health Assessment Questionnaire, r=0.55 (p<0.001); American College of Rheumatology global functional class, r=0.56 (p<0.001); and number of limited joints, r=0.65 (p<0.001). CONCLUSION: Our results provide evidence that the Pediatric EPM-ROM scale is a valid instrument to measure joint ROM in JRA.     

Stressors in ICU: perception of the patient, relatives and health care team

Objective: To compare the evaluation of the stressors present in the intensive care unit (ICU) from the point of view of the patient, relatives and the multiprofessional team and to identify differences and similarities with regard to the perception of stressors in order to optimize patient care. Design: Cross-sectional analytical survey. Setting: General ICU of a private hospital. Patients and participants: From April 1^st to June 30^th, 1996, 50 ICU patients during the first week of their ICU stay, 50 of their respective relatives and 50 members of the professional team directly involved in the care of these patients. Measurements and results: The Intensive Care Unit Environmental Stressor Scale (ICUESS) was administered to all patients. The relatives and health care professionals were asked to complete the ICUESS on the basis of their perception of the patient's stressors. Being in pain, having tubes in the nose or mouth, being restrained by tubes and being unable to sleep were considered by the patients, relatives and health care professionals as the main stressors. The professional team evaluated the intensity of the stressors higher than either the family or the patient. No statistical significance was detected between the intensity of the stressors as evaluated by the patient and the intensity evaluated by relatives and by the professional team. Conclusions: Being in pain, being unable to sleep and having tubes in the nose and/or mouth were pointed out as the major stressors by the three groups. There was no statistically significant correlation between the total stress scores of the patients and their relatives (r = 0.193), between the patients and the team (r = –0.002), or between the total scores of the team and the relatives (r = –0.185). The results suggest that the views of the relatives and the professional team concerning the stressors have some similar points compared to the evaluation made by the patient himself, although the intensity of the evaluation for each group corresponds to its own perception. Received: 3 March 1999 Accepted: 19 October 1999     

Wilson's disease: a report of 4 cases. Follow-up study of a patient for 33 years

Wilson's disease is a rare disorder with relatively few studies about long term evolutional aspects. The aim was to relate 4 cases emphasizing their polymorphic clinical and laboratorial aspects and the evolutional study of one of them for 33 years and whose treatment enabled the disappearance of the symptoms and the signals of the disease.     

Late results on the surgical treatment of Chagasic megaesophagus with the Thal-Hatafuku procedure.

BACKGROUND: Chagas' disease has a wide distribution in Central and South America. It is endemic in 21 countries, with 16 to 18 million persons infected and 100 million at risk. Surgical treatment of achalasia from Chagas' disease is the first choice in advanced stages. The aim of this study was to analyze the late clinical followup of 50 patients operated on for Chagas megaesophagus with the Thal-Harafuku procedure. STUDY DESIGN: During the period of January 1966 to January 1993, 50 patients suffering from advanced achalasia from Chagas' disease were submitted to the Thal-Hatafuku procedure. The patients answered a questionnaire concerning the most relevant postoperative symptoms. The Thal-Hatafuku procedure was performed as the first surgical option (46 patients), and on reoperations because of failure of other surgical techniques (4 patients). RESULTS: The mean followup was 63.11 months for the 44 patients with longterm followup. Postoperative complications included surgical site infection (3 of 50 patients), urinary infections (3 of 50 patients), atelectasis (2 of 50 patients), pleural effusion (2 of 50 patients), and deep venous thrombosis (1 of 50 patients). The main symptoms found in the postoperative period were dysphagia (20 of 44 patients), heartburn (11 of 44 patients), vomiting (13 of 44 patients), and retrosternal pain (6 of 44 patients). Eleven patients of the 44 remained asymptomatic at the end of the followup period. Outcomes were analyzed according to the modified Visick classification. Visick classes I and II represented 25% and 27.3%, respectively. Eighteen patients (40.9%) were classified as Visick III. CONCLUSION: We conclude that the Thal-Hatafuku operation is a therapeutic option that should be considered in the treatment of achalasia of the esophagus secondary to Chagas' disease, in advanced cases.     

Dental anomaly: dens evaginatus (talon cusp).

Dens evaginatus is a developmental anomaly characterized by the occurrence of an extra cusp shaped as a tubercle projecting from the palatal or buccal surfaces (talon cusp). In the anterior dentition, dens evaginatus is more commonly found in the maxilla and on the palatal surface of the tooth. The authors present a case of dens evaginatus in a maxillary central incisor, in which the evagination was removed and routine endodontic treatment was performed.     

Cationic liposome–DNA complexes as gene delivery vectors: Development and behaviour towards bone-like cells

Modulation of the biological pathways responsible for fracture repair and osteogenisis may accelerate regeneration. Gene therapy is an alternative method for the release of osteogenisis-stimulating proteins into tissues. The development of vectors for gene release is still a problem in terms of ethics and techniques. In this work we evaluated whether cationic liposomes constitute a valuable strategy for the release of genetic material into bone tissue cells as non-viral vectors. Liposomes were prepared with 1,2-dioleoyl-3-trimethylammonium propane (DOTAP)–2-dioleoyl-sn-glycero-3-phosphatidylethanolamine and DOTAP–cholesterol, and characterized according to their size, zeta potential, DNA protection capacity and cytotoxicity. Transfection studies were also carried out using pCMVβ-gal plasmid in two osteoblastic cell lines (MG63 and MC3T3-E1) and in the 294T line, varying the charge ratio and the applied DNA dose. Inclusion of transferrin to increase the expression was also tested. The results suggest that there is great dependency between the transfection activity and the lipid formulation, the charge ratios of the complexes, the applied DNA dose and the cell type. There were even some differences concerning both osteoblastic lines under study. The cells of the MC3T3-E1 line present greater expression levels than the cells of the MG-63 line. The conjugation of the transferrin with the complexes contributes to the increase in transfection levels, possibly due to an increase in internalization of complexes. It is thus a good strategy for inducing the expression of specific genes in osteoblast-like cells.